Failure of the polymerase chain reaction (PCR) to detect human papilloma virus (HPV) in transitional cell carcinoma of the bladder

In contrast to cervical and penile carcinoma, in situ hybridization techniques have not been able to demonstrate an association of HPV with transitional cell carcinoma (TCC) of the bladder. The introduction of the polymerase chain reaction (PCR) in the mid 1980s has significantly increased the ability to detect small quantities of viral DNA over conventional methods. Thus, we designed a study to determine if the PCR technique was able to demonstrate the presence of HPV DNA in TCC specimens. The study involved both consensus primers directed toward the E1 and L1 open reading frames of the HPV viral DNA, specific for HPV 6, 11, 16, 18, 31, 33. Thirty-three TCC specimens were studied (Fresh: 8, paraffin embedded: 25). Seven were Grade I, nine Grade 11, seventeen Grade III; thirteen were superficial (Stages O and A) and twenty were invasive or metastatic (Stages B or Higher). None of the patients had known evidence of clinical HPV infection. In each experiment, the CaSki cell line was used for a positive control. In addition, the results of the PCR reactions were confirmed by Southern blot hybridization. Neither the PCR by direct ethidium bromide viewing, nor the Southern blot technique detected HPV DNA in any of the TCC specimens. This was in contrast to our controls, which were positive by both techniques. Although it is possible that there is a link between HPV and TCC, our results suggest that there is no such association among the HPV types tested.